Pulsed Radiofrequency Therapy at Different Voltages on Dorsal Root Ganglia Using Multifunctional Catheter to Treat Low Back Pain: A Comparative Retrospective Study.

BACKGROUND: Applying pulsed radiofrequency (PRF) to the dorsal root ganglion (DRG) is an electrical neuromodulation technique, a valid complementary therapeutic treatment for failed back surgery syndrome (FBBS). Peridurolysis, when applied to vertebral canal adhesions, can be performed with dedicated catheters, providing patients with the benefits of mechanical, electrical, and pharmacological techniques. OBJECTIVES: The aim of this study was to evaluate PRF's effects on the DRG as part of FBSS treatment at different follow-up times, comparing 2 groups of patients exposed to distinct levels of voltage (100 V vs. 45 V) from a PRF generator. STUDY DESIGN: A retrospective observational study was performed. SETTING: The study was conducted on a sample of patients from an Italian hospital. METHODS: PRF's effects on the DRG as part of FBSS treatment were evaluated through the Numeric Rating Scale (NRS) and the monitoring of 155 patients' opioid consumption at 3, 6, and 9 months. A Cosman® G4 model PRF generator was used. During follow-up periods, the Friedman test was applied to detect differences in outcomes between the 2 groups of patients, who were treated with different levels of voltage. RESULTS: The most frequent diagnosis (61.29%) was FBBS in patients at a mean age of 64 (± 11.8) years old. All patients were treated with PRF on the dorsal ganglion, with the addition of a drug mixture. Most were treated with 100 V (62%). A statistically significant decrease (P < 0.001) in the NRS score emerged both as a whole and in the 2 distinct groups. Moreover, the group of 100 V patients showed a significant (P = 0.0360) reduction in the use of opioids. LIMITATIONS: This observational retrospective study was based on a convenience sampling that involved a limited number of patients. CONCLUSIONS: E-field technology is the only way to generate a constant 38°/42° PRF and 100 V level throughout surgical interventions (respecting the exposure times "set" by the operator). The patient will not feel any pain or electric current because the generated milliamperes will be greatly reduced.

Histological examination of skin tissue in the porcine animal model after application of a new monopolar radiofrequency.

OBJECTIVES: This study aims to evaluate the safety of the radiofrequency device and its efficacy in various treatment and refrigeration modes. METHODS: Four 4-week Bama miniature pigs were used in this study, and four repeated treatment sites were selected on the pig's abdomen, each site consisting of 6 different treatment and cooling modes, with radiofrequency device (YouMagic; WE Medical Technology Co., Ltd.) administered every 3-5 s for a total of five treatments. The handheld infrared thermometer (HIKMICRO; Hangzhou Hikmicro Sensing Technology Co., Ltd.) was used to monitor the surface temperature of skin. Twenty minutes after the completion of treatment, a biopsy of the treatment and control area was performed on the pigs using a 4-mm biopsy punch. One-month after the treatment, samples were obtained using surgical scalpels. After that we used proper staining to estimate the therapeutic efficacy. At last, SPSS and Image J were used to proceed to the next step of analysis. RESULTS: During the therapy, no side effects were observed apart from mild transient erythema caused by the heating of skin temperature, staining of biopsy samples taken 20 min after treatment showed no serious damage of dermis. After 1 month of treatment, it can increase collagen I and elastin production. In addition, increases in energy setting at a standard pass number also increased the expression of collagen I. Meanwhile, we also found an increase in the thickness of the dermal layer among all treatment groups. CONCLUSIONS: The new monopolar radiofrequency instrument possesses excellent therapeutic safety. After 1 month of treatment, it can increase collagen I and elastin production in 2-month-old Bama miniature pigs.

Targeting the dermis for melasma maintenance treatment.

Melasma relapse is almost common after discontinuation of conventional treatment. Recent studies suggesting that photoaging dermis is the main pathomechanism of melasma, emphasize the dermal targeting therapy. We investigated maintenance effect of microneedling radiofrequency (RF) for melasma treatment. Subjects with melasma were administered oral tranexamic acid and triple combination cream for 2 months and a randomly assigned half face was treated with RF. After discontinuation of conventional therapy, the half face RF continued monthly over 6 months. Modified melasma area severity index (mMASI) score and L* value by a chromameter were collected monthly. Fifteen subjects were enrolled and eleven completed the 8-month study. At 2nd month of conventional therapy, all subjects showed improvement with a 64% reduction in mMASI score. With continuous RF treatment, the improvement was well maintained; whereas in untreated side, the Δ L* gradually decreased, returning to the baseline after the conventional therapy ended. The continuous microneedling RF therapy is beneficial in maintaining the conventional therapy of melasma suggesting the protective effect of dermal targeting therapy in melasma development.(Clinical Trial registration number: NCT05710068, date of first registration: 02/02/2023).

Subjective evaluation of monopolar radiofrequency treatment by patients in aesthetic rejuvenation.

OBJECTIVE: To assess the subjective experiences of patients following monopolar radiofrequency (RF) treatment for facial rejuvenation and anti-aging purposes. METHODS: A study involving 50 female patients (aged 30-70 years, Fitzpatrick skin type III and IV) who received a single session of RF treatment. Exclusion criteria comprised active infections, skin diseases, pregnancy, or history of recent anti-aging treatments. Thirty-four patients completed a 10-question questionnaire after 3 months of treatment. RESULTS: Among the respondents, 82% expressed satisfaction with the RF treatment, reporting significant improvements primarily in the mid and lower face, and eyelids. Mainly, patients noted improvements in skin laxity (52.9%), skin texture (17.6%), and skin tone (11.7%). Notably, 73.5% noticed changes within 1-2 months post-treatment, with the peak effect observed at 1-2 months. Mild complications (swelling and erythema) were reported, usually resolving within a week. The mean pain score was 1.94 (±0.66), indicating mild to moderate discomfort. DISCUSSION: Monopolar RF devices, apply high-frequency electric currents generating heat, stimulating collagen production for skin tightening. This study's unique focus on detailed subjective patient experiences provides insights valuable in clinical settings, aiding clinicians in managing patient expectations and achieving optimal results. The satisfaction rates align with previous findings, emphasizing RF treatment's efficacy in addressing facial laxity, especially in the mid and lower face. Positive feedback extended beyond skin tightening, encompassing skin texture and tone improvements. While the study's observation period was 3 months post-treatment, longer-term studies are warranted for comprehensive assessments. CONCLUSION: The study underscores the efficacy of monopolar RF device, as a non-invasive and effective anti-aging treatment. The findings contribute to diversifying the RF market, potentially aiding clinicians in optimizing patient care. Considering the growing complexity of patient demands and treatment responses, this study serves as a valuable reference for clinicians engaging in RF treatments.

Evaluation of the efficacy of pulsed radiofrequency therapy in patients with lumbosacral radicular pain: An analysis of single-center data.

OBJECTIVES: Lumbosacral radicular pain (LRP) is one of the most common causes of neuropathic pain. This pain often arises from inflammation in the dorsal root ganglia (DRG) or spinal nerves. Despite various treatment modalities, success rates are not very high in chronic LRP cases. Pulsed radiofrequency (PRF) therapy, frequently applied to the DRG, is widely used, but its effectiveness is often questioned in various studies. The primary aim of our study is to evaluate the effectiveness of PRF treatment in 154 patients. METHODS: Patients with LRP for longer than 3 months, treated with PRF, were included in this study. To assess the efficacy of PRF treatment, numerical rating scale (NRS) scores were evaluated at the 4th-week and 6th-month follow-ups. RESULTS: The NRS scores were significantly lower at the 4th-week and 6th-month follow-ups compared to pre-treatment levels (p<0.001). However, there was no significant difference between the mean NRS scores at the 4th week and 6th month. CONCLUSION: Success in interventional pain procedures is often considered as at least a 50% reduction in pain scores. The success rate for PRF treatment for LRP in the literature varies between 30% and 60%, which is similar to our findings at the 4th week and 6th month. PRF treatment is widely used due to its low side-effect profile and cost-effectiveness in the long term. There is no fully standardized practice regarding procedural aspects, such as the duration of the application, and prospective studies with larger participation are needed.

Novel Approach to Facial Rejuvenation by Treating Cutaneous and Soft Tissue for Wrinkles Reduction: First Experience from Multicenter Clinical Trial.

Background: Facial aging is determined by skin quality and the condition of underlying muscles, which contribute to the overall appearance by lifting heavy facial structures. Objective: This study aims to assess the safety and effectiveness of the novel radiofrequency (RF) and high-intensity facial muscle stimulation (HIFES) technology for treating wrinkles by facial tissue remodeling. Methods: This trial assessed the 3-month data of 24 subjects seeking facial wrinkles treatment. All subjects received four treatments, with a device utilizing RF and HIFES. The evaluation included a two-dimensional photographs assessment according to the Fitzpatrick Wrinkle and Elastosis Scale (FWES) and a three-dimensional (3D) photograph analysis for facial appearance. Therapy comfort and subject satisfaction were assessed. Results: Based on the data of 24 subjects (56.5 ± 2.0 years, skin types I-IV), the significant improvement increased up to 3 months (-2.3 points, p < 0.001) post-treatment. 3D photographs analysis documented notable cutaneous and structural rejuvenation and coincided with FWES evaluation, underlining the positive subjective appreciation of the results with 20.4% average wrinkle reduction at 1 month, further increasing to 36.6% wrinkle reduction at 3 months. Conclusion: Documented by both subjective and objective evaluation tools, the RF and HIFES procedure for facial rejuvenation was found to be effective for treatment of wrinkles and skin texture. ClinicalTrials.gov Identifier: NCT05519124.

Radiofrequency therapy as an effective treatment for granulomatous cheilitis: A CARE case report.

INTRODUCTION: Granulomatous cheilitis is a rare disorder characterized by recurrent, idiopathic, and painless lip swelling. The diagnosis is proven by histopathological examination. The unknown aetiology and poorly understood underlying mechanism contribute to the difficulty in establishing an effective treatment. This case study proposes the effectiveness of radiofrequency therapy in the management of refractory granulomatous cheilitis. CASE SUMMARY: A 68-year-old patient presented with hypertrophy and swelling of the lower lip, and a biopsy revealed actinic cheilitis. The patient underwent lip shaving and an advancement mucosal flap, and definitive histologic examination confirmed the diagnosis of granulomatous cheilitis. No other signs of orofacial granulomatosis were observed, and the complementary aetiological study was negative for systemic disease. The lip swelling reappeared and persisted, which interfered with the quality of life. Hence, radiofrequency therapy was performed in the submucosal and subdermal layers of the lip, resulting in significant aesthetic and functional improvement and no further relapses after five years. DISCUSSION: The management of granulomatous cheilitis is challenging. The current mainstay treatment is corticotherapy or reduction cheiloplasty in severe cases. Radiofrequency has potential as a treatment option in debilitating macrocheilia, presenting worthy long-lasting functional and aesthetical results, with minimal morbidity.

Efficacy and safety of a noninvasive, home-based radiofrequency device for facial rejuvenation: An open-label, intraindividual controlled trial.

BACKGROUND: Wrinkle formation is the most visible characteristic of facial aging. Radiofrequency (RF) technology is currently utilized to reduce facial wrinkles and contribute to skin rejuvenation. OBJECTIVE: To analyze the efficacy and safety of a noninvasive, home-based RF device applied for facial rejuvenation in Chinese people. METHODS: A single-center, open-label, intraindividual controlled trial was performed on subjects who received an 8-week treatment of the RF device. A total of 22 female individuals aged 25-60 years with Fitzpatrick skin type III-IV were enrolled. Efficacy of treatment was subjectively evaluated using the Fitzpatrick Wrinkle Classification Scale (FWCS) assessed by physician or overall satisfaction of subject with a 10-point VAS, and objectively using the skin ultrasound examination as well as the 3D skin analysis system. Adverse event was recorded at each visit. RESULTS: In comparison with the baseline, evaluator-assessed FWCS scores showed significant improvement at 4 weeks (p < 0.005) and 8 weeks (p < 0.005) after treatment. All subjects reported different degrees of improvement in facial wrinkles after 8 weeks of treatment. The results of skin ultrasound examination revealed significant increase of the dermal thickness at week 8 (p < 0.05) as compared to the baseline. In addition, a significant decrease in the proportion and density of perioral wrinkles evaluated by the 3D skin analysis system was observed from baseline to week 4. The treatment was well-tolerated, and no serious adverse event was observed. CONCLUSION: This noninvasive, home-based RF device was effective in improving skin texture and elasticity with a safe and well-tolerated treating procedure.

Ablación percutánea de tumores renales: resultados a largo plazo / Percutaneous ablation of renal tumors: long-term outcomes

Objetivo: Valorar resultados a largo plazo de la ablación de tumores renales analizando eficacia, supervivencia a largo plazo y factores asociados con complicaciones y éxito terapéutico. Material y métodos: Revisión retrospectiva de 305 ablaciones, en general usando radiofrecuencia con electrodos desplegables, sobre 273 lesiones de tumores renales entre mayo de 2005 y abril de 2019. Se analizaron supervivencia, eficacia primaria y secundaria y complicaciones relacionándolas con diversos factores del paciente y características de los tumores tratados. Resultados: La creatinina en sangre media previa al tratamiento fue de 1,14 mg/dL y al año de 1,30 mg/dL (p <0,0001). Hubo complicaciones en el 13,25% de las ablaciones (mayores, 4,97%) que se relacionaron con la edad (p=0,013) y el diámetro tumoral (p <0,0001). La eficacia primaria fue del 96,28%. Las lesiones de más de 4 cm fueron más propensas a presentar ablaciones incompletas (p=0,002). La eficacia secundaria fue del 95,28%. El riesgo de recurrencia se relacionó solo con el tamaño del tumor (p=0,02). La supervivencia global fue del 95,26% al año, 77,01% a los 5 años y 51,78% a los 10 años. No se observaron diferencias en función de la naturaleza maligna o benigna de la lesión tratada. La mortalidad aumentaba en pacientes con creatinina superior a 1 (p=0,05) o ASA >2 (p=0,0001). Conclusiones: La ablación percutánea de tumores renales es una técnica de altísima eficacia, que permite igualar el pronóstico de un carcinoma renal, tras el tratamiento, al de una lesión benigna. Las complicaciones son muy infrecuentes y se relacionan, al igual que la supervivencia, con la edad y el estado de salud del paciente.(AU)

Objective: To evaluate the long-term outcomes of renal tumor ablation, analyzing efficacy, long-term survival, and factors associated with complications and therapeutic success. Material and methods: We retrospectively reviewed 305 ablations (generally done with expandable electrodes) of 273 renal tumors between May 2005 and April 2019. We analyzed survival, primary and secondary efficacy, and complications according to various patient factors and tumor characteristics. Results: Mean blood creatinine was 1.14 mg/dL before treatment and 1.30 mg/dL after treatment (p <0.0001). Complications were observed in 13.25% of the ablations, including major complications in in 4.97%. Complications were associated with age (p=0.013) and tumor diameter (p <0.0001). Primary efficacy was 96.28%. Incomplete ablation was more common in lesions measuring> 4 cm in diameter (p=0.002). Secondary efficacy was 95.28%. The only factor associated with the risk of recurrence was the size of the tumor (p=0.02). Overall survival was 95.26% at 1 year, 77.01% at 5 years, and 51.78% at 10 years, with no differences between patients with malignant and benign lesions. Mortality was higher in patients with creatinine>1 (p=0.05) or ASA> 2 (p=0.0001). Conclusions: Percutaneous ablation is extremely efficacious for renal tumors; it improves the prognosis of renal carcinoma to the point where it does not differ from that of benign lesions. Complications are rare. Like survival, complications are associated with age and overall health status.(AU)

Radiofrequency and pulsed electromagnetic field application following liposuction-Clinical evaluation of performance and safety.

OBJECTIVE: With more than 1.5 million performed procedures, liposuction was the second most performed esthetic surgical procedure all over the world in males and in females in the year 2020. The objective of this open-label, evaluator-blinded study was to assess the efficacy and safety of an energy-based device that combines multipolar radiofrequency with pulsed electromagnetic field (PEMF) in patients that underwent liposuction. MATERIALS AND METHODS: A total of 30 subjects, of whom 24 were females (80%), with a mean age of 48.4 ± 11.0 years (range: 27-69 years) and a mean weight of 69.5 ± 11.7 kg underwent unilateral treatment with radiofrequency and application of PEMF after bilateral liposuction. One month after the last of a total of six weekly treatments, skin elasticity, visco-elasticity and net elasticity, as well as subject reported satisfaction on a 5-point scale ranging from -1 (worse) to 3 (very much improved) and esthetic improvement ranging from 0 (very unsatisfied) to 4 (very satisfied) rated by three independent reviewers were assessed. RESULTS: Three independent and blinded reviewers rated the improvement of the treated side on average as 1.17 + 0.07 compared with baseline. Subjects were very satisfied with their treatment, with a mean score of 3.24 (0.03) out of 4 at the 1-month follow-up visit. Cutometer measurements showed no significant changes. CONCLUSION: This study revealed that the subjective satisfaction with the results of the application of RF and PEMF after liposuction is high, while at the same time the esthetic appearance as rated by independent raters improved on the treated side.

The effect of consecutive facet medial branch radiofrequency denervation and dorsal root ganglion pulse radiofrequency therapy on lumbar facet joint pain.

OBJECTIVES: The aim of this study was to evaluate the efficacy of consecutive facet medial branch (FMB) radiofrequency denervation (RFD) and dorsal root ganglion pulse radiofrequency (DRG PRF) therapy in patients with chronic lumbar facet joint pain. METHODS: The study included 27 patients with chronic lumbar pain who had ≥50% pain reduction after FMB block for suspected lumbar facet syndrome and subsequently underwent FMB RFD together with PRF to the adjacent DRG. The patients were retrospectively analyzed in terms of age, gender, pre-procedure symptom duration, history of previous back surgery, FMB RFD and DRG PRF level and side, and numerical rating scale scores immediately before and at 1, 3, and 6 months after the procedure, and subjective pain reduction at 6 months post-treatment. Treatment success was defined as ≥50% subjective pain reduction at 6 months. RESULTS: A total of 19 women and 8 men with a mean age of 57.7±12.4 years were analyzed. Twenty patients (74.1%) had no prior history of low back surgery. The success rate of the procedure in terms of subjective pain reduction at 6 months was 82.5% (n=25). The subjective percentage of pain reduction at post-procedure 6 months was significantly lower in patients with a pre-procedure symptom duration of 12 months or longer compared to those whose pre-procedure symptom duration was <12 months (p=0.04). CONCLUSION: Our study results show that the analgesic efficiency of DRG PRF added to FMD RFD treatment can be increased in patients with short symptom durations.

Radiofrequency Microneedling.

Radiofrequency microneedling is a technique that allows energy to be delivered to specified target depths in the skin via needle electrodes and measures temperature and impedance within the tissue. This method of delivery and real-time feedback has increased safety and efficacy, providing clinically significant improvements in skin laxity, rhytids, and cellulite.

Técnica de radiofrecuencia ablativa ecoguiada del nervio sural para el dolor crónico de tobillo. A propósito de un caso / Ultrasound-guided radiofrequency ablation of the sural nerve for chronic ankle pain: A case report

El dolor crónico en la cara lateral del tobillo relacionado con la neuralgia sural es una patología poco frecuente. El nervio sural inerva la sensibilidad del borde posterolateral de la pierna, así como del borde dorsolateral del pie. En ocasiones la neuralgia sural es resistente al tratamiento conservador, pudiendo afectar a la esfera psicoemocional y social del paciente. Describimos el caso de un paciente de 54años con dolor neuropático en territorio del sural y con el antecedente de varias cirugías de tobillo. Tras tratamiento conservador sin éxito, se realiza radiofrecuencia ablativa ecoguiada en nervio sural con posterior cese completo del dolor sin efectos secundarios. Nos proponemos dar importancia a la ecopalpación en consulta de un médico rehabilitador, así como describir la radiofrecuencia ablativa ecoguiada como una técnica segura y eficaz para la neuralgia sural que no responde a tratamiento conservador. Sin embargo, se necesitan más estudios de calidad para corroborar estos resultados.(AU)

Chronic lateral ankle pain related to sural neuralgia is a rare pathology. The sural nerve innervates the sensitivity of the posterolateral border of the leg, as well as the dorsolateral border of the foot. On occasions, sural neuralgia is resistant to conservative treatment and can affect the patient's psycho-emotional and social sphere. We describe the case of a 54-year-old patient with neuropathic pain in the sural territory and a history of several ankle surgeries. After unsuccessful conservative treatment, ultrasound-guided ablative radiofrequency is performed in the sural nerve with subsequent complete cessation of pain without side effects. We propose to give importance to ecopalpation in the consultation of a rehabilitation physician, as well as to describe ultrasound-guided ablative radiofrequency as a safe and effective technique for sural neuralgia that does not respond to conservative treatment. However, more quality studies are needed to corroborate these results.(AU)

Radiofrecuencia térmica como alternativa en el tratamiento del dolor neuropático localizado persistente por atrapamiento de un nervio colateral de la mano / Thermal radiofrequency as an alternative in the treatment of persistent localized neuropathic pain due to entrapment of a collateral nerve of the hand

El dolor neuropático localizado (DNL) es una causa relativamente frecuente de dolor musculoesquelético cuya prevalencia puede llegar a representar el 60% de las condiciones de dolor neuropático. Su aparición puede asociarse a numerosas patologías (herpes, diabetes, etc.). Una causa menos habitual sería la compresión directa de una rama nerviosa periférica. Su diagnóstico suele ser clínico, ya que pruebas complementarias como las neurofisiológicas no aportan datos definitivos. Como medidas terapéuticas disponemos de analgésicos orales, anticonvulsivantes, parches cutáneos analgésicos y acciones intervencionistas, entre las que se incluye la radiofrecuencia (RF). La RF térmica consiste en el paso de una corriente eléctrica a través de una aguja alcanzando un aumento controlado de temperatura con el que se consigue una lesión ablativa nerviosa.Se presenta un caso donde se propone como alternativa terapéutica la RF térmica del nervio colateral de la mano, cuyo atrapamiento es el causante del dolor, obteniendo una mejoría clínica satisfactoria.(AU)

Localized neuropathic pain (LNP) is a relatively common cause of musculoskeletal pain, which can be present in up to 60% of neuropathic pain conditions. Its appearance can be associated with numerous pathologies (herpes, diabetes, etc.). A less common cause would be the direct compression of a peripheral nerve branch. Its diagnosis is usually clinical since complementary tests such as neurophysiological tests do not provide definitive data. As therapeutic measures we have oral analgesics, anticonvulsants, analgesic skin patches and interventional actions, including radiofrequency (RF). Thermal RF consists in the transmission of an electric impulse through a needle reaching a controlled increase in temperature with which a nerve ablative injury is achieved.We present a clinical case where thermal RF of the collateral nerve of the hand is proposed as a therapeutic alternative, whose entrapment is the cause of pain, obtaining a satisfactory clinical improvement.(AU)

Nonablative monopolar radiofrequency for the reduction of facial pores and sebum excretion in Thai patients: A novel approach.

BACKGROUND: Enlarged facial pores are visible topographic features of the skin that have been associated with cutaneous photoaging and increased sebum production. It has remained a common dermatologic concern, gaining a significant number of in-clinic consults. Available treatment modalities often operate on a single mode of action, consequently offering limited and short-term outcomes. OBJECTIVE: This study aimed to evaluate the long-term efficacy and safety of a nonablative monopolar radiofrequency (NMRF) for pore tightening and sebum output reduction in Thai patients. METHODS: Nineteen patients with enlarged pores underwent two sessions of NMRF treatments at 4-week intervals. The measurements of pore volume, skin texture, average pore size, sebum production, and skin elasticity were quantified using Antera® 3D imaging system, dermoscopic image analysis with ImageJ software, Sebumeter® and Cutometer®. Clinical evaluation by two dermatologists was done using blinded clinical photographs. All objective and subjective assessments were done at the baseline, a month after the first treatment, and during follow-up visits 1, 3, and 6 months after the last treatment. Adverse effects were also recorded during each visit. RESULTS: Seventeen out of the 19 subjects completed the study protocol. The mean pore volume significantly reduced by 24% from the baseline at 1 month after the first treatment (p < 0.016). The pore volume continued to decrease by 34% and 38% a month (p < 0.001) and 6 months (p < 0.001) following the final treatment, respectively. Sebum excretion likewise significantly decreased from baseline by 39% (p = 0.002) and 36% (p < 0.001), 3 and 6 months after the second treatment, respectively. Skin texture and elasticity also significantly improved following two NMRF sessions. The objective assessments of the pore appearance corresponded to subjective clinical evaluations. The treatment was well-tolerated without significant side effects, such as dyspigmentation, textural alteration, and scarring. CONCLUSION: NMRF appears to be effective and safe for the reduction of pore size and sebum production, with therapeutic outcomes persisting up to 6 months after two treatment sessions.

[Efficacy and safety of modified Hartel approach in the treatment of primary trigeminal neuralgia with radiofrequency thermocoagulation].

Objective: To assess the efficacy and safety of modified Hartel approach in the treatment of primary trigeminal neuralgia with radiofrequency thermocoagulation. Methods: A total of 89 patients with primary trigeminal neuralgia in Nanjing Drum Tower Clinical College of Xuzhou Medical University from July 2021 to July 2022 were prospectively included, and were divided into experimental group (n=45, modified Hartel approach: selecting 2.0 cm lateral to and 1.0 cm below angulus oris as insertion point) and control group (n=44, traditional Hartel approach: selecting 2.5 cm lateral to the angulus oris as insertion point) according to the random number table method. There were 19 males and 26 females in the experimental group, and aged (67.6±8.8) years. Meanwhile, there were 19 males and 25 females in the control group, and aged (64.8±11.7) years. All the patients were treated by CT-guided radiofrequency thermocoagulation. The success rate of one-time puncture, number of punctures, the time of puncture, operation time, numerical rating scale (NRS) scores and complications were recorded and compared between the two groups. Results: The success rate of one-time puncture in experimental group was 64.4% (29/45), which was higher than that in control group 31.8% (14/44) (P<0.05). The number of punctures [M (Q1, Q3)], the time of puncture [M (Q1, Q3)] and operation time in the experimental group were 1 (1, 2), 218 (206, 378) s, (19.9±2.7) min, which were less than those of control group [2 (1, 3), 390 (231, 598) s, (27.0±3.9) min] (all P<0.05). The NRS scores [M (Q1, Q3)] of 1 day, 1 month and 3 months after surgery in the experimental group were 1 (1, 2), 1 (0, 2) and 1(0, 1), respectively, which were lower than the baseline level [6 (6, 7)] (all P<0.05). The NRS scores [M (Q1, Q3)] of 1 day, 1 month and 3 months after surgery in the control group were 1 (1, 2), 1 (0, 2) and 1 (0, 2), respectively, which were lower than the baseline level [6 (6, 7)] (all P<0.05). There was no statistically significant difference in the incidence of nausea and vomiting, facial numbness, and decreased masticatory muscle strength between the two groups (all P>0.05) In the experimental group, two patients had puncture needles into the oral cavity, with timely detection and replacement of puncture needles, and no infection occurred. There was no cerebrospinal fluid leakage and decreased corneal reflex in both groups. Conclusion: The modified Hartel approach can significantly improve the success rate of one-time puncture via foramen ovale, reduce the operation time and the incidence of postoperative facial swelling, which is a safe and effective puncture method.

Lumbar Facet Syndrome and the Use of Radiofrequency Ablation Technique as an Alternative Therapy: A Systematic Review / Síndrome facetária lombar e a utilização da técnica de ablação por radiofrequência como terapia alternativa: uma revisão sistemática

Abstract Lumbar facet syndrome stands out as a significant cause for the increasing prevalence of back pain complaints. Alternatives such as radiofrequency (RF) ablation may be a therapeutic option to relieve the chronic pain associated with this condition. It is critical to analyze the effectiveness of lumbar facet syndrome treatment using the traditional RF ablation technique and the relief generated by it in chronic low back pain (CLBP). This study is a systematic review using the following inclusion criteria: title, observational studies, clinical trials, controlled clinical trials, clinical studies, and publications over the last 17 years (from 2005 to 2022). The exclusion criteria included papers addressing other themes and review articles. The databases used for data collection included the Medical Literature Analysis and Retrieval System Online (Medline), PubMed, Scientific Electronic Library Online (SciELO), Lilacs, and Biblioteca Virtual em Saúde (Virtual Health Library in Portuguese). The query used the following terms: facet, pain, lumbar, and radiofrequency. The application of these filters yielded 142 studies, and 12 were included in this review. Most studies indicated that the traditional RF ablation technique was beneficial in relieving CLBP refractory to conservative treatment.

Resumo Em um contexto de aumento da prevalência de queixas de dores na coluna, a síndrome facetária se destaca como um importante causador. Alternativas como a ablação por radiofrequência (RF) podem ser uma opção de terapia para alívio da dor crônica que essa patologia pode causar. É necessário analisar a eficácia do tratamento da síndrome facetária pela técnica de ablação por radiofrequência tradicional e o alívio gerado nas dores lombares crônicas (DLC). O presente estudo trata-se de uma revisão sistemática cujo os critérios de inclusão para análise foram: título; estudos observacionais; ensaios clínicos; ensaio clínico controlado; estudos clínicos e publicação nos últimos dezessete anos (2005-2022). Já os critérios de exclusão foram: artigos que abordavam outras temáticas e artigos de revisão. As bases utilizadas para coleta de dados incluíram Medical Literature Analysis and Retrieval System online (Medline), Pubmed, Scientific Electronic Library Online (SciELO), Lilacs, Biblioteca Virtual em Saúde. Os termos utilizados para a pesquisa foram: facet; pain; lumbar; radiofrequency. Aplicando-se os filtros foram encontrados 142 estudos, 12 foram incluídos. Os estudos em sua maioria apontaram ser benéfica a técnica de ablação por radiofrequência tradicional no alívio das dores lombares crônicas refratárias ao tratamento conservador.

Efectividad de la diatermia por radiofrecuencia en el tratamiento de las patologías de rodilla. Una revisión sistemática / Effectiveness of radiofrequency diathermy in the treatment of knee pathologies. A systematic review

Objetivo La diatermia es una terapia que permite aumentar la temperatura y el metabolismo de los tejidos biológicos mediante la emisión de radiaciones electromagnéticas. A pesar de que esta forma de terapia está ampliamente extendida, no existen revisiones acerca de su utilidad en el tratamiento de patologías de rodilla. Por eso, en la presente revisión bibliográfica se valoró la efectividad de la diatermia por radiofrecuencia como tratamiento conservador en el abordaje de diferentes patologías de rodilla. Material y métodos Se realizó una búsqueda de ensayos clínicos controlados y aleatorizados en las bases de datos PubMed, Web of Science (WOS) y Scopus con las palabras clave «Radiofrequency», «Capacitive», «Resistive», «Dielectric», «Knee» y «Diathermy». Se seleccionaron ensayos clínicos aleatorizados publicados desde 2011 hasta la fecha actual, en inglés y en español. Para valorar la calidad de estos, se usó la escala PEDro. Resultados Cuatro ensayos clínicos aleatorizados fueron seleccionados atendiendo a los criterios de inclusión y exclusión. Todos ellos mostraron resultados positivos a favor del grupo experimental en las variables de dolor percibido y funcionalidad. Conclusión La diatermia por radiofrecuencia es una terapia no invasiva eficaz para mejorar la funcionalidad y reducir el dolor a corto plazo en pacientes con diferentes patologías de rodilla (AU)

Objective Radiofrequency diathermy is a treatment technique that increase temperature and metabolism of the biologic tissues by the emission of electromagnetic radiation. Even though this therapy is widely used, there are no reviews about its effectiveness in the treatment of knee pathologies. For this reason, the aim of this systematic review is to assess the efficacy of radiofrequency diathermy as conservative treatment for different knee pathologies. Methods A bibliographic search of randomized clinical trials was carried out in Pubmed, Scopus and WOS, using «Radiofrequency», «Capacitive», «Resistive», «Dielectric», «Knee» and «Diathermy» as descriptors. Only randomized clinical trials in English and Spanish from 2011 to date were chosen. PEDro scale was used to assess the quality of the studies. Results Four randomized clinical trials were selected according to the inclusion and exclusion criteria. All studies showed positive results in favor to the experimental group regarding pain reduction and knee function. Conclusions Radiofrequency diathermy is an effective non-invasive therapy to improve the quality of life, the functionality and the pain in short-term in patients with different knee conditions (AU)

Management of vaginal laxity through bilateral wall tightening without mucosal excision.

BACKGROUND: Vaginal tightening or vaginoplasty has been gaining popularity, while validated methods of evaluation and treatment are still lacking. Herein, we describe a bilateral wall tightening technique for vaginal laxity and evaluate the feasibility of this method. METHODS: From April 2020 to September 2021, 25 women with vaginal laxity underwent vaginal tightening, and 22 women were included in this retrospective observational study. The inclusion criteria were as follows: participants with at least one delivery and reported vaginal laxity, but without a history of underlying diseases. Vaginal pressure tests and questionnaires were used to evaluate vaginal laxity and sexual quality before and 6 months after the surgery. RESULTS: The study included 22 women (aged 29-46 years), and the follow-up period was 14.1 ± 3.3 months. The score based on the vaginal laxity questionnaire was improved as a result of surgery (preoperative median: 2.00, interquartile range [IQR]: 1.00-2.00; postoperative median: 5.00, IQR: 5.00-6.25, p < 0.001). The vaginal pressure increased from 2.3 ± 1.8 mm/Hg to 21.4 ± 3.7 mm/Hg. Sexual distress changed from 24.2 ± 8.9-16.1 ± 4.8 after surgery (p < 0.001), and sexual dysfunction with an average score of 20.1 ± 10.6 before surgery improved after the procedure (26.0 ± 10.8, p < 0.001). Women also reported improved scores in desire, arousal, orgasm, and satisfaction. In addition, there were no intraoperative complications or significant events during the follow-up period. CONCLUSIONS: Bilateral vaginal tightening without mucosal excision is a feasible and effective surgical approach for the management of vaginal laxity.